Dr. Nurse

No level of nursing scholarship has a greater minority representation disparity than the very top. Nurses of color make up less than 10% of the total enrollment in nursing doctoral programs, according to the most recent annual enrollment study by the American Association of Colleges of Nursing (AACN). It’s no wonder, then, that nursing schools, faculty and professional nursing organizations are teaming up to increase those numbers by providing encouragement, funds and programs to increase minority nurses’ access to PhD-level education.

Why the push? The low numbers have far-reaching implications. Because a doctoral degree is a must for researchers who seek funding for their studies, the scarcity of doctorally prepared nurses of color is a contributing factor to the current disparity in health outcomes for racial and ethnic minority populations.

“Minority researchers are more likely to study minority populations, with the goal of improving the health care options available to their own people,” explains Pamela Hammond, RN, PhD, FAAN, dean of Hampton University’s School of Nursing in Hampton, Va. In 1998, the school became the first historically black university to offer a PhD in nursing.

Research is only one area that is suffering due to the lack of minority nurses with doctoral degrees. Much national and international health care policy-making requires this degree for entrance into very selective circles of debate and planning. Without the presence of nurses of color at the table, minority populations are without a voice to advocate for their interests.

Still another consequence of the severe shortage of PhD-prepared minority nurses is a lack of faculty diversity at the nation’s nursing schools, a factor that Hammond sees as a major reason why more minority students don’t pursue a doctorate. “If [minorities] are not seeing people with PhDs in their community, they don’t see themselves becoming one,” she says.

But besides these altruistic issues, there are other good reasons for nurses of color to pursue a doctoral degree. Completing this level of study gives nurses access to many opportunities for professional advancement that otherwise would not be available.

“I have a strong interest in research development in the geriatric area, and I want to make a difference,” explains PhD Candidate Sheila Cannon, RN, MSN, a third-year student at Hampton who will receive her degree this May. Currently an assistant professor at Norfolk State University, Cannon feels the doctorate will not only open doors for her in the research field but also have a positive impact on her teaching career.

Many experts in nursing academics say she’s right. “Without this higher degree, you can teach but it may be limited to the associate or diploma level,” notes Dula Pacquiao, RN, EdD, CTN. Pacquiao, a Filipino American, is director of the Transcultural Nursing Institute at Kean University in New Jersey, a majority school.

Why are there so few minority nurses enrolled in doctoral programs? Hammond cites the same factors that contribute to the underrepresentation of minorities at all levels of nursing: lack of role models, lack of encouragement and lack of money.

“A lot of African Americans may think that this is a goal that’s unreachable,” says Phyllis Henderson, RN, MSN, another member of Hampton’s first nursing PhD class. “No one is giving us the encouragement to pursue advanced degrees. When I earned my bachelor’s degree, no one at the school said, ‘Come back and work on your master’s.’”

It was only when she joined the faculty of Florida A&M University School of Nursing, another historically black school, several years after graduation that Henderson received the support that persuaded her to go for her PhD. “The faculty there constantly pushed me to pursue higher degrees. Even now, people here are telling me to come back and do post-doctorate work.”

Choose Your Program Wisely

Finding supportive faculty members is key to success in doctoral studies, as is finding a program that’s the right match for your educational goals. Don’t assume the best place to get your doctorate is the school where you earned your master’s, and don’t choose a school because it’s the only PhD program in your state. Be open to relocating if necessary.

“Too often, students only look at programs in their local area,” Hammond cautions. “Look for a school that will give you access to working in your specific area of interest.”

When evaluating prospective programs, look closely at the reputations and accomplishments of their faculty members. A doctoral program provides you with a rare opportunity to work one-on-one with nationally recognized leaders. Choose it wisely.

A great way to learn about the program offerings and campus environments of various PhD programs is by networking at regional and national nursing conferences. Here you can learn through casual conversation things that glossy college catalogs don’t tell you. How do different schools encourage minority students? Are faculty members accessible? How much flexibility do students have to tailor the program to their needs? Remember, every nurse attending a conference is an alumnus of at least one school. You’ll also find plenty of faculty members dispersed in the crowd. Such encounters provide a unique opportunity to test the waters before you apply.

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When you choose a school for your doctoral studies, chances are you’ll also be choosing a degree. Some programs offer traditional PhDs (technically, a doctorate in the philosophy of nursing) while others offer DNS (Doctor of Nursing Science) and still others offer EdD (an educational doctorate earned almost exclusively by nurse educators).

Pacquiao encourages students to consider their degree choice carefully. Although her own doctorate is an EdD, she believes the traditional PhD is usually the best choice for most nursing students. While the quality of education may be very similar regardless of the particular degree, she argues, the PhD will open more doors because the outside world is more familiar with it.

“There are many very good EdD programs at excellent schools,” she says. “But when you go out in nursing with an EdD, you almost always have to explain your degree. It’s the same thing with a DNS—it’s so specific to nursing that people in other fields don’t recognize it. Very often, job requirements state ‘PhD or equivalent is needed.’ If you have another type of doctoral degree, you’re always the alternative. I wish schools would just give one degree and make it clear to everyone.”

Another important factor to keep in mind when choosing a doctoral program is that you don’t just want to be admitted–you want to graduate, too. Find out how committed a program is to retaining minority students and making sure they complete their degrees. Can they give you an example of how they’ve gone the extra mile to help a student stay in school? Sometimes, it can be something as simple as having the faculty offer more flexible office hours to accommodate working students.

Two numbers will help you evaluate your chances: the number of minorities admitted versus the number that graduate.

“If minority enrollment and graduation numbers match, the program must be doing something right,” Pacquiao says. “On the other hand, if minority students are being admitted but when the class graduates, everyone is of one color, that tells you something is going wrong in the process.”

Who Gets In—and Why

Compared to the task of researching and choosing the right school, applying for admission to a doctoral program is the easy part. While doctoral slots are at a premium, the application process is almost identical to that of most master’s programs.

“In many ways, it’s not any more difficult than getting accepted into a master’s program,” Hammond agrees. “The biggest difference is that fewer spaces are available in PhD programs, so the competition for those spaces is greater. In terms of the application process itself, it’s not going to be any different.”

Potential doctoral candidates should begin the process at least a year before the start of the program they wish to enter. For example, if you hope to start your studies in fall 2003, you should spend summer and fall 2002 learning more about possible schools, choosing your references and taking a new GRE (Graduate Record Examinations)—which most schools require for PhD admission even if you successfully passed the test when applying for your master’s studies.

By spring 2003, you should be ready to make a final decision on where to send your applications. You should also have finalized the required goals statement outlining what you hope to accomplish in the program and in your post-doctorate career.

Now you’re ready to start putting your application package together. You’ll need at least three letters of reference, GRE scores, transcripts and an interview with a faculty member at your prospective school.

There are also unofficial requirements that vary from school to school.

Some programs place a high value on graduate-level research and would not consider admitting a student who did not write a master’s thesis. Similarly, institutions with a heavy emphasis on teaching may not want to admit a student who has never stood before a classroom. Once again, the key is to find the right fit.

Hampton University is somewhat unique in that it will accept GRE scores from a prospective doctoral student’s master’s application, rather than requiring him or her to retake the test. Instead, Hampton puts a heavier emphasis on the goals statement.

“We want to make sure that what you plan to do is in line with our program objectives,” Hammond explains, adding that Hampton’s program concentrates on family-related health research. “We would not admit someone who wanted to study international health care policy. That student would need to look for another school that emphasized policy and policy-making.”

While PhD admission committees do review transcripts, grades only come into play when Cs have been earned in core courses. According to Hammond, “We don’t want to see Cs in research courses. In a doctoral program, you are going to have to do lots of research and be able to work independently.”

Students still enrolled in a master’s program have the advantage of being able to make adjustments in their current studies to better prepare themselves for their doctoral education plans and remedy any academic deficiencies. Hammond suggests using your elective course options to gain introductory experience in your career objectives.

“If you want to teach, take an education course. Use your electives wisely,” she advises.

Likewise, Hammond continues, if you’re an MSN candidate who hopes to move into a research career, this is the time and place to get the research experience that will help strengthen your application for PhD-level study. “Try to work with faculty on research projects, even if it’s not a paid assistantship. You may just be doing interviews or entering data, but this keeps you in the ‘this is what research is all about’ mode.”

The Hampton dean also has some advice for students who want to return to school for a PhD after being away from the academic setting for a number of years. Hammond speaks from experience, having earned her master’s in 1978 and her PhD in 1992.

“When I went back for my doctorate, I took just one course in my first semester,” she recalls. “It gave me a great opportunity to talk with faculty and see how much work was going to be involved. Going back as a part-time student for a while helps get you back into thinking like a student again.”

How Am I Going to Pay For This?!

Doctoral degrees don’t come cheap. So when it comes to financing your PhD education, here are two words to live by: Be aggressive.

The first place to start scouting for funds is the doctoral program you are planning to attend. Because many nursing schools are eager to add minority PhD candidates to their student bodies, they are ready, willing and able to provide financial assistance, Pacquiao reports.

Consider a Long-Distance DoctorateEver since Duquesne University School of Nursing in Pittsburgh became the first nursing program in the country to offer an online PhD program, a growing number of nursing schools have implemented or are considering similar high-tech options to help make doctoral education accessible to a more diverse range of students.For example, Hampton University School of Nursing in Hampton, Va., the first historically black nursing school to offer a PhD program, recently expanded its program to include a distance-learning curriculum. Among the Hampton students who are benefiting from this alternative are a PhD candidate in Florida who seldom visits the campus and one in New Orleans who flies in once a week.Even though most students in Hampton’s doctoral program are local to the area, they still benefit from the increased flexibility cyber-learning offers. Chris Orten, RN, MSN, a third-year doctoral student, is one example of a PhD candidate who attends traditional courses on campus but has also taken advantage of the online courses, because of the convenience they provide for both students and faculty.The online curriculum has given her the opportunity to learn from leading professors around the country whose geographic locations and busy schedules would not have permitted them to travel to the Hampton campus, Orten explains. “We have had really good professors online, people who are nationally known nursing experts with a lot of research experience.” She also enjoys the flexibility of being able to take a class on her home computer. “It just adds to the variety of resources available,” she says.

Don’t be afraid to be up front with your needs and inquire about fellowships, graduate assistantships, scholarships and federal and state grants or loans. Most schools also have federal traineeship funds available. This money is provided by the federal government and distributed, within certain guidelines, at the discretion of the school.

Unfortunately, minority nursing students are often unable to take advantage of such resources because they are caught in a common financial aid Catch 22. Many of them work full time, and the income they earn usually pushes them out of financial aid eligibility brackets. Furthermore, the demands of their jobs leave them no choice but to attend school part time—but most graduate-level grants, fellowships and scholarships are only awarded to full-time students.

Keep in mind, however, that your success is important to your school. If you get into a dire financial bind, talk to someone about it before abandoning your studies completely. Schools sometimes have a never-talked-about policy of deferring tuition payments until after graduation for particularly needy students, or stretching tuition payments over the semester. Talk to your advisor to make sure you’re aware of all your options.

Your search for financial assistance shouldn’t stop with your university. Be sure to seek funds from the community as well. “Always look at local sources,” Hammond emphasizes. “A hospital may need a study done. If it fits your area of interest, you might be able to do the study as part of your PhD research. Hospitals are willing to pay stipends for that type of work.”

Another increasingly common source of financial assistance is nursing employers, especially if the facility is committed to staff development. Company-sponsored tuition reimbursement often helps nursing assistants become nurses, RNs become BSNs and BSNs become MSNs. While many nurses assume that you have to be a university faculty member for your employer to financially support your quest for a PhD, this is no longer the case.

For example, Hammond cites the Veterans Administration—one of the nation’s largest employers of minority nurses–as one employer that does provide tuition assistance to employees seeking PhD degrees. She adds that the government agency is one of several employers that are considering replacing traditional tuition reimbursement programs with more immediate assistance. The VA will now pay the money at the time tuition is due.

Talk to your supervisor and your company’s human resources department to find out if funds are available.

Getting Others to Pay

Many great nursing research careers began with a large manila envelope mailed to the National Institute of Nursing Research (NINR). The Washington, D.C.-based agency, one the National Institutes of Health (NIH), awards grants to pre-doctoral students to pay for research costs and provide a stipend that can be used for books, tuition or living expenses. The number and amount of grants awarded varies depending on the availability of funds and the quality of proposals submitted.

While the pre-doctoral research grant program is very competitive, applying for a grant doesn’t have to be a scary process, says Program Director Janice Phillips, RN, PhD, FAAN, who is African American. Guidelines are available at the NINR Web site (www.ninr.nih.gov) and program directors (PDs) are eager to talk with applicants. If you are interested in applying, contact the PD in charge of your area of interest; a guide to the appropriate contact persons is also posted on the site.

Phillips is concerned that the stereotype of cold hearts in ivory towers may make some minority doctoral students needlessly hesitant to call. “We are real people,” she stresses, “and we want to facilitate doctoral students’ progress. Our responsibility is to provide as much assistance as we possibly can.”

Phillips says the application process for any type of research grant should begin within your doctoral program. Talk to your academic advisor. Look at successful applications submitted by former students, and talk to students and faculty that have received research funds. She also offers this checklist of do’s and don’ts:

Apply early. Phillips advises doctoral students to apply for grant funding for their first year of study. “Submitting early may give you time to get feedback from your PD and address those areas of your application that need improvement.” The earlier you apply, the more funding you may receive, she adds. Too many students wait until their second year to apply, only to learn that the research could have been funded in its first year, too. And if your grant proposal isn’t selected for funding in the first year, apply again the following year.

Be detailed when describing your previous education. Descriptions of the courses you’ve taken and those you plan to take in your doctoral studies give grant reviewers a feel for where you are in your career. Too many times, applicants use broad, sweeping generalizations instead of providing details. Don’t simply repeat the standard language from your advisor’s listing. Instead, talk about what you studied and accomplished in each course. “Be very clear when describing your research training,” Phillips explains. “Let us know how your previous courses fit into the research currently under consideration.”

Don’t be afraid to go outside your concentration to pick up needed skills.Phillips did her pre-doctoral research on breast cancer screening. Her work was enhanced after a professor suggested she take a course from a discipline other than nursing. “Until then, it had never dawned on me to take a course in cancer epidemiology,” she says. “Courses in other disciplines are allowed [in NINR grant proposals] if they help you in pulling everything together.” Again, explain the need for any such supplemental courses in your application.

Choose your sponsor carefully. Every research grant must have a sponsor–an experienced professor or researcher whose role is to help you keep your project on track. According to Phillips, “It’s important to have a good match between the application and the sponsor. Reviewers look at that carefully. If your proposed research is on women’s health, your sponsor or co-sponsor should have experience in that area.” If you’re planning to pursue a grant, she adds, start looking for potential sponsors early, since this may ultimately affect your choice of which doctoral program to attend.

The cheapest research isn’t always the best. While asking for too much money can doom your grant’s chances of being accepted, so can asking for too little. Grant reviewers expect your proposed budget to be reasonable, but they also expect it to be realistic. In fact, Phillips advises students to ask for a little more money than they anticipate needing. “If you request enough funding to cover three years and the research actually takes four, you can’t go back for more funding,” she points out.

Finally, keep in mind that the NINR is by no means the only source for nursing research grants. Hammond encourages doctoral students to seek grant money not only from the government but also from foundations and private companies. For example, drug companies sometimes consider grant applications. And the American Cancer Society often funds PhD-level research in areas related to cancer. (See Academic Updates elsewhere in this issue.)

Check organizations’ Web sites for information on funding possibilities, then call to request application guidelines. Remember that deadlines are firm—once the application date has passed, the door is closed for that year, regardless of how worthy your research is.